AMERICA/HAITI - XXXII World Day of the Sick: "The health system is on the verge of collapse, but there is not only violence on the island"

Saturday, 10 February 2024


by Antonella Prenna

Jérémie (Agenzia Fides) - "Our hospital in Port-au-Prince remains a small beacon of hope in the face of the darkness that envelops the city today," says Father Massimo Miraglio, the only Italian Camillian missionary present in Haiti for 18 years.

On the occasion of the XXXII World Day of the Sick on Sunday, February 11th, and the XXIV edition of Medicine Collection Day, which will take place from February 6th to 12th, the missionary describes the tragic state in which the health system of the Caribbean country is, and at the same time the population's great desire for redemption.

"At the moment" said Father Massimo in an interview with Fides, "the island's health system is in a truly catastrophic situation, both in the capital and in the provincial towns, almost all hospitals, health centers and clinics are closed due to the unrest and the lack of medical equipment is closed. This is particularly serious in the poorest areas, in the working-class areas, where tensions and violence are at their highest.
All the small structures that until some time ago still offered a service, albeit minimal, had to close one after the other, and the population no longer has the opportunity to solve the health problems that have tragically increased in recent years due to the clashes and violence that are destroying the country. Just think of the many injured in the clashes between the gangs, to the problem of malnutrition, which promotes disease, especially among vulnerable groups such as children and the elderly, and to the chronically ill who do not receive life-saving medicines. It is a real health disaster, especially in Port-au-Prince, but not only, because this reality has now spread to the entire province. Unfortunately, many hospitals have now thrown in the towel, are closing and the staff is trying in every possible way to leave the country, in short, the situation is extremely serious".

A small glimmer of hope in this dramatic picture is the “Foyer Saint-Camille” hospital in the la Plaine district in the north of the capital. "Despite the difficulties, the problems, the pressure and the threats," reports Father Massimo, "the hospital has always remained open. It is run by the Haitian Camillian religious who have been trained over time and who now, with great courage and determination, will continue to operate the hospital and do everything possible to be able to continue to take care of the population, especially the most vulnerable."

Haiti has always had a poorly functioning and, above all, completely paid healthcare system. "The poor," says the Camillian missionary, "were excluded and the few rich could be treated for the simplest things in the capital, but for more complicated illnesses they often went abroad, especially to the United States. It has always been an exclusive healthcare system in which the poor were excluded and always had great difficulties with even the smallest health problems. In recent years the situation has become really dramatic. Especially in the last two years, the system in Port-au-Prince, the only reference point where there were still a few hospitals, gradually 'rotted' and finally collapsed completely due to the prevailing violence and total chaos. Due to the difficult situation in the country, many doctors, many well-trained nurses, have left Haiti and emigrated to other countries. At our Camillian Hospital in Port-au-Prince, the staff, all Haitians, are well trained, willing and up to the task, but they experience extremely stressful moments. Often they can't even go home, they are forced to work long shifts and then stay in the hospital, even overnight, to rest and then return to work. It is often difficult even to leave the hospital and return to the places where they live due to the violence in the capital. Several nurses, doctors and medical staff have been robbed, kidnapped and extorted in recent years, some have never returned home."

The situation has also worsened in the provinces. "If in the past the provincial towns did not have structures capable of meeting the minimum health needs," continues Father Miraglio, "there were structures, hospitals. In Jérémie for example, the town, where I have been working for almost twenty years, there was a hospital that was certainly not functioning properly, that was certainly having great difficulties, but that was still able to offer some services to help the population, of course without treating the most serious cases, but at least able to treat the ordinary, the simplest things. Unfortunately, the situation has really collapsed in the last two years. There is no more water, there is no light, there are no medical devices or medicine; people have to buy everything from syringes to anesthetics, antibiotics and anti-inflammatories. When you go to the hospital you have to take everything with you and you know that you will have to spend a lot of money. In the last three years, the number of qualified health workers has also decreased in Jérémie. Many have left the hospital and many have left permanently. On the one hand we find the hospital's structural deficiencies, truly catastrophic services, and on the other hand the staff is increasingly demotivated and frustrated. In the last few months in Jérémie hospital we have often seen women who came to give birth being taken to the delivery room without electricity. We have seen cesarean sections performed by the light of a smartphone, often with inadequate medication; an operating room that functions very poorly, where only small operations are carried out, where it is very easy to catch any infections and where operations are carried out with a torch.
In the emergency room, stiches are done without anesthesia.

Father Massimo points out the importance that Medicine Collection Day also has for Jérémie's reality. "For many years, as a Camillian who has chosen to be close to sick and poor people, I have been running a service in which I distribute free medicines from Italy. Every evening I receive dozens of people who come with medical prescriptions asking for medicines. In these last few months, before my arrival in Italy, the number of people has increased significantly. This is also an opportunity for me to thank from the bottom of my heart all those who help us send medicines on World Sickness Day, and for this activity that the 'Banco Farmaceutico' has been carrying out for many years with great success. The medicines are sent not only to institutions and associations in Italy, but also to people in countries like Haiti, who are extremely poor and needy. It should not be underestimated that in the poorest countries the quality of the medicines on the market is very poor. Most of those found in Haiti are produced in countries where there is absolutely no control. Or they are produced in let's say first world countries but made to be exported to poor countries, where there is no type of control and therefore of very poor quality. It follows that the activity of the Pharmaceutical Bank, which is also celebrated every year on the occasion of World Sick Day, is a very precious activity because it allows us to collect quality medicines to support our activities". "As for the commitment that I have been carrying out in Jérémie for 18 years, a few years ago we started the construction of the small hospital, which unfortunately we have not yet completed because of the situation in the country, the difficulty in attracting volunteers from Italy to work with the locals, the technicians and the bricklayers on site. Unfortunately, for the last three years, for safety reasons, we have had to stop the work and the influx of volunteers who wanted to help us because it is too dangerous. One year alone In 2023 there will be at least 6,000 kidnappings with the aim of extortion, these are the reported kidnappings, but there are at least as many that have not been reported", said Father Massimo.

"In addition to the mission that I carry out together with my colleagues, since August 2023 I have also been the parish priest of Pourcine, a town in the mountains where the healthcare needs are currently immense," he continues. "It is a very remote place in the mountains, which is very difficult to reach. To get from Jérémie to Pourcine near the Pic Macaya, the second highest mountain in the country at 2400 meters, we will travel at least 7 to 8 hours if we are lucky, but even more. We cover the first part of the route by motorbike or a solid car, and then it's at least another 3 hours on foot to get there. So imagine the needs in such a remote area, with no outpatient clinic and very far from the hospital in Jérémie, as well as several hours' walk from a first small clinic that is often unable to do almost anything. "It therefore remains a priority for the parish to build an outpatient clinic as quickly as possible to meet the basic health needs of the population."

"Days and actions like these, organized by the 'Banco Farmaceutico', are very important because they help to bring hope and support the efforts of all those who, even in Haiti, do not want to give up but want to fight, struggling to return to the light, to be able to lead a normal life again, to resume their activities. The help that reaches us through these medicines is important to support our service in such a difficult time for people; to be able to continue to hope, to fight so that Haiti can finally rise again and be a country in which people can live again, albeit with fewer resources, but with dignity," emphasizes Father Massimo in conclusion. (Agenzia Fides, 10/2/2024)